GHANA HUMAN DEVELOPMENT REPORT 2004 BREAKING THE HIV/AIDS CHAIN: A HUMAN DEVELOPMENT CHALLENGE University of Ghana t n e m p o el ev D f r dge o Knowle Copyright 2005 By UNDP-UNFPA, Ghana All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission of UNDP-UNFPA, Ghana ISBN: 9988-8293-2-9 Cover Design: Koku Mensah Dotse, Pixel Graphics, Accra. Typesetting and Printing: Buck Press Limited, Accra. Photographer: Griffiths Attoh, Hallmark Photos, Accra. FOREWORD The Republic of Ghana has not been spared pandemic in order to achieve the sixth of the the global HIV/AIDS pandemic. The Millennium Development Goals (MDGs) of country has had its fair share of the impact combating HIV/AIDS by 2015. of the disease, which is increasingly becoming a threat to the nation's The Report opens the debate once again on development. At the end of 2003, it was the direction in which Ghana is heading in estimated that 3.6% of the adult population the fight against HIV/AIDS vis-à-vis human aged 15 to 49 years were living with development issues. It gives a general HIV/AIDS. assessment of HIV/AIDS in Ghana and the world at large, and also promotes a holistic Progressively, global attention on HIV/AIDS approach to dealing with the disease. has expanded considerably from a narrow Above all, the Report provides a platform for focus on medical characteristics and the the various initiatives that are being taken to search for a vaccine to a more vigorous combat the disease, highlighting the best campaign for behavioural change to halt its practices and the least effective methods. spread. Available evidence indicates that while the need for comprehensive care and Ghana must continue to expand her support continues to grow, traditional response to HIV/AIDS despite the legion of structures for providing these functions are problems facing her, especially the shrinking with the effect of the disease. challenge of achieving economic growth Happily, State, Community-Based and accelerated national development. Organisations (CBOs), NGOs and donors This is because HIV/AIDS has proved to be have all yielded to pressure to expand the an implacable enemy, and constitutes one focus of the HIV/AIDS campaign to of the greatest threats not only to Ghana's embrace treatment, including psycho- development but also to the whole social care and support. This is in continent's development in the 21st Century. recognition of society's moral responsibility It is for this reason that government is doing towards people infected with, or affected by its best to eradicate the disease or curb its the disease. In recent times, the spread by 2015, the global date set to wipe government has enhanced its contribution HIV/AIDS, malaria and other diseases from to the fight against the pandemic by the face of the earth. providing antiretroviral drugs to some AIDS patients. The fight against HIV/AIDS must include both personal and collective commitment Many seminars have been held to train peer and strategies. The greatest challenge of all advocates and leaders both at national and is for behavioural change within the society, local levels to help disseminate information especially in terms of sexual practices, and a to sensitise the public on the causes and commitment to increased education and prevention of the disease. This has created awareness promotion. It must be stressed at the much needed awareness within all times that abstinence is best, if not, communities all over the ten regions of the protection is sensible. But whichever country. However, it is yet to be proved that approach is adopted to fight HIV/AIDS, half the sustained education has yielded the the battle would have been won if required dividend of behavioural change. Ghanaians would recognize that the disease threatens our collective survival. The theme for Ghana's Human Development Report 2004: “Breaking the HIV/AIDS Chain: A Human Development Challenge” hits the nail right on the head. The theme provides the right focus as Ghanaians continue to contend with the Ghana Human Development Report 2004 PREFACE The fact that HIV/AIDS is no longer solely a The UNDP HIV/AIDS Leadership health problem but a crucial development Development Programme has focused its problem in many countries is widely current efforts at generating a core of recognized and accepted. Ghana is no committed Leaders to facilitate capacity exception. It is the understanding in the building of institutional programmes; country that the epidemic is quietly workplace programmes and has affected devastating the country; therefore response policy issues in the country's multi-sectoral to the epidemic must be quick and response strategy. UNDP trained 100 appropriate. The national HIV prevalence institutional leaders and 80 community rate of 3.6 percent in Ghana in 2003 is still level workers. The people trained included low relative to that of neighbouring parliamentarians, Chiefs, NGOs, CBOs, countries. This fact can be interpreted in S e c t o r M i n i s t r i e s a n d Wo m e n two ways: If the country response is quick Organizations. and appropriate enough, the impact of the epidemic can be successfully minimized; UNDP exercises oversight in the District however if not, it will pose a severe Response Initiative (DRI) on HIV/AIDS by challenge to the country. At present, the providing technical assistance to the country's response is not sufficient, but it is Ministry of Local Government and Rural still in the formative stage. This is why Development. The DRI is the major vehicle UNDP is assisting the country in for implementing HIV/AIDS programmes at mainstreaming HIV/AIDS into its the community level. development agenda, in the process of a c c e l e r a t i n g s u s t a i n a b l e h u m a n It is to underscore UNDP's belief on the development. In its effort, UNDP's primary importance of developing a holistic partner is the Government of Ghana, approach to addressing the HIV/AIDS particularly the Ghana AIDS Commission pandemic that this year's National Human (GAC) as the government's counterpart. Development Report (NHDR) focuses on UNDP is also in close collaboration with the HIV/AIDS. members of the Expanded UN Theme Group on HIV/AIDS, which responds to The thrust of the report is to put together the various needs and demands of the country various initiatives that are taken to combat in search of viable strategies for scaling up the disease, highlighting especially the best the national response to HIV/AIDS crisis in practices, but also noting the less effective Ghana. methods. The report is to positively galvanize the adoption of multi-sectoral In the broad context of the above, specific and multi-disciplinary approaches to the Expanded UN Theme Group' interventions management and study of HIV/AIDS and include the following: the dissemination of information about the disease in Ghana. In this process, Enhancing Ministry of Food and stakeholders should find gaps that they can Agriculture's (MOFA) Capacity to contribute their resources to fill. Control HIV/AIDS Support to Ghana AIDS Response The publication of the report is timely as it Fund (GARFUND) Project comes at a time when we are inclined to A Study of the Status of HIV/AIDS take for granted the devastating nature of Orphans towards the Formulation the epidemic because of the comparatively of National Policy in Ghana low prevalence rate in Ghana. Development of Best Practice Materials in Ghana (District UNDP has played the lead role in the Response Initiative Best Practices) production of the Human Development Promoting Partnerships for Scaling Report on HIV/AIDS in collaboration with up of the DRI iv Ghana Human Development Report 2004 UNFPA and ISSER of the University of formulation and national development Ghana, Legon. agenda as well as for the reading public. This report will serve as the instructional material to inform the crafting of the Strategic Direction of HIV/AIDS interventions in Ghana over the next five (5) years. Alfred S. Fawundu I highly recommend this Ghana Human Development Report for adoption as a tool RESIDENT REPRESENTATIVE, UNDP and for mainstreaming HIV/AIDS into policy RESIDENT COORDINATOR, UN v Ghana Human Development Report 2004 OVERVIEW PREAMBLE Treatment is now available though at great cost. For poor countries like Ghana The world is under serious challenge to find perhaps the more viable options are direct resources to achieve the Millennium behaviour change for people to reduce the Development Goals (MDGs); at the same risk of infection and of spreading it to time it faces the ugly reality of the potential others. devastation that lies in wait if the HIV/AIDS pandemic remains unchecked, particularly This report, with its theme: Breaking the in Africa. AIDS is now in the top five list of HIV/AIDS Chain: a Human Development leading causes of death in the world (WHO, Challenge, explores: (2000). The Declaration of the United Nations General Assembly Special Session the links between HIV/AIDS and on HIV/AIDS (UNGASS) and the Millennium efforts to promote social well-being; Development Goals both acknowledge the the social, cultural, religious and strong links between HIV/AIDS and current economic aspects of the prevention and efforts to achieve human security through management of the pandemic; poverty reduction and overall human the reorganisation of the health care development. By the end of 2003, over 40 services to equip care-givers to deliver million people worldwide were living with appropriate and adequate care to HIV.